suprapubic

[MF31]

Peter down having suprapubic done as I’m sitting waiting I’m just hoping this will make thing easier for both of us any views

[ReverendBadger]

Easier than what is the question. If you can share more details of Peter's problems with the bladder I will comment in more detail. In the meantime here is my personal overview.

With MSA it is a neurogenic bladder. The exact nature of bladder dysfunction will vary over time as the MSA progresses. This can be rapid e.g. overnight or can be intermittantly variable i.e. one set of symptoms on Monday and a different set on Tuesday.

For these reasons conventional urological approaches, typically drugs, often have a poor success rate or eventually prove useless as they are trying to deal with a specific failure mode and the sneaky MSA keeps changing what goes wrong.

If the bladder won't empty itself reliably every few hours every day, even with drugs, then there are only two possibilities;

1. Plumbing alterations

2. Electrical control

The latter would be great but they don't yet have these devices refined enough so that one can have a little fob like a car key with a buttton for "Pee" and a button for "Store". Maybe one day...

So practically, for the UK, you have a choice of plumbing. A bit of man made tubing. 3 choices.

1. Intermittant urethral catheter

2.Permanent urethral catheter

3. Permanent Suprapubic catheter

Note that "permanent" refers to the system, the tubing itself is changed regularly.

All 3 alternatives have their pros and cons. Intermittant catheterisation will only work well if the bladder behaves itself when there is no catheter in. i.e. sphincters closed and bladder muscle not activated, and it needs to be like that reliably all the time. This is, of course, not necessarily the case with an MSA neurogenic bladder. (my problem right now !).

[MF31 in reply to ReverendBadger]

urethral catheter he just kept bypass so this was left as the best option I pick him up later from hospital so fingers crossed all goes well with this option.

[Huntes]

hi I hope the super pubic works well for you both, my husband has been on a waiting list to have one fitted for months, I think it must be a good thing as you will be able to sleep better without having to get up for the loo at night

Good luck and do let us know how you get on and how long it takes for everything to settle in.

[MF31 in reply to Huntes]

brought him home today he is sleeping now so hopefully all will be well only problem is getting him to drink we are also waiting for feeding tube as he has no appetite and has lost so much weight it’s all a worry

[Blueirises]

My husband, with MSA, had one fitted. The sooner the better. Gone are the urinary infections, risk of urosepsis, damage to urethra and other such problems. Keep the entry site clean, it never really healed up, so that needs care. Changing it every 12 weeks so much better than many urethral changes, worst was 3 in three days.

[MF31 in reply to Blueirises]

I’m hoping DN comes out tomorrow as hospital were useless didn’t give any information on cleaning and didn’t know when he should have his first shower after op so I actually don’t know what I’m doing.